Nothing yet...and I'm so confuzzled!
Well, I've been using the LH tests since CD10 and it's currently CD15. I've gotten a faint line next to the control line on all 6 tests, but no sign of ovulation yet. I'm still puzzled on what to expect if I do ovulate or not. I mean I know each woman experiences things differently and some don't notice anything while others have egg-white CM and can feel when they ovulate. Given my cycle history, I don't think I've EVER ovulated before, so I'm finding myself worrying and stressing over this not working.
I know the next step will be to go to IUIs if the Letrozole doesn't work, but somehow I'm thinking that the blood tests on CD24 aren't enough to see if it's working. I mean, what if the Letrozole is just not enough and I need a trigger? Will my RE even think about that before going straight to IUIs? Why am I not being monitored more than one simple blood test?
Today's been one of those days where I keep dropping things or messing something up all because my thoughts are preoccupied with questions about my RE and the care he's given me thus far. Compared to a lot of the ladies on here, I feel like I'm being gypped. In the past 6 months I've seen him twice and seen his understudy twice (once for the HSG and on my last visit where I saw him and my RE both). I think I like the understudy better, he went into detail about the 3 options I have (meds alone, IUI and IVF) and was nice about things (including my weight). Whereas I feel my RE is assuming I should know various things already.
The last u/s I had was on April 6, 2009. I have the gyne report which says "There are multiple follicles in the both (sic) ovaries. RT ovary - there is dominant follicle, measures 1.2 x 0.9 cm." with "Normal pelvic ultrasound, with no abnormalities detected in the uterus, ovaries or adnexa. Follicular activity is seen bilaterally, but the ovaries are not enlarged." under that. No one has explained any of this to me, other than to say everything looks normal. I have my blood test report from three days later as well, showing all my levels. Again, this was not explained to me at all, other than a quick 'no signs of PCOS' comment made in passing.
Should my RE be monitoring me more, especially knowing that the last two rounds of Letrozole did not work? Should I be asking for more monitoring for the next cycle if this round doesn't work according to the blood tests? Are the blood tests (checking my progesterone levels) reliable enough to be used on their own? I'm so confused about this. I want to take control of my fertility treatments, but I have no clue what's going on. I'm sitting here looking at the reports (which I just found in a file from when I moved and had to bring them with me for my current RE since the old office was having technical glitches with their new systems) and wondering what all of this means and if enough testing has been done to find the cause of my IF.
I shouldn't complain really, my old RE (whom I saw a total of 3 times) was worse than my current RE. Dr. H (old RE) was very vague about everything. He sent me for tests and then never explained them to me. I had the ultrasound and the blood tests and then saw him twice after that for Clomid scripts and to go over the results of the tests, but he just said that I don't have PCOS as I don't have any signs other than the abnormal facial hair growth and weight issues.
Dr. R (current RE) has explained things and sent me for more tests, but I haven't seen the full reports from those tests. And though Dr. R tells me more than Dr. H ever did, I still haven't gotten anything other than what I already know (I have symptoms of PCOS but no evidence of having it). I can read these reports, but I don't fully understand what they mean in terms of my IF.
Dr. R is the only RE in my town, but I can't help thinking he's not working with me. I keep wondering if I should ask for a copy of all my reports and send them off to another RE and ask just for a second opinion. I can't afford to travel to find another RE, and though I would love to move out of my current town, I'm not giving up my schooling either. Waiting 2 years isn't an option. Dr. R is treating me, even if I feel it's not enough. I just don't know what to do, I'm just confuzzled!
I know the next step will be to go to IUIs if the Letrozole doesn't work, but somehow I'm thinking that the blood tests on CD24 aren't enough to see if it's working. I mean, what if the Letrozole is just not enough and I need a trigger? Will my RE even think about that before going straight to IUIs? Why am I not being monitored more than one simple blood test?
Today's been one of those days where I keep dropping things or messing something up all because my thoughts are preoccupied with questions about my RE and the care he's given me thus far. Compared to a lot of the ladies on here, I feel like I'm being gypped. In the past 6 months I've seen him twice and seen his understudy twice (once for the HSG and on my last visit where I saw him and my RE both). I think I like the understudy better, he went into detail about the 3 options I have (meds alone, IUI and IVF) and was nice about things (including my weight). Whereas I feel my RE is assuming I should know various things already.
The last u/s I had was on April 6, 2009. I have the gyne report which says "There are multiple follicles in the both (sic) ovaries. RT ovary - there is dominant follicle, measures 1.2 x 0.9 cm." with "Normal pelvic ultrasound, with no abnormalities detected in the uterus, ovaries or adnexa. Follicular activity is seen bilaterally, but the ovaries are not enlarged." under that. No one has explained any of this to me, other than to say everything looks normal. I have my blood test report from three days later as well, showing all my levels. Again, this was not explained to me at all, other than a quick 'no signs of PCOS' comment made in passing.
Should my RE be monitoring me more, especially knowing that the last two rounds of Letrozole did not work? Should I be asking for more monitoring for the next cycle if this round doesn't work according to the blood tests? Are the blood tests (checking my progesterone levels) reliable enough to be used on their own? I'm so confused about this. I want to take control of my fertility treatments, but I have no clue what's going on. I'm sitting here looking at the reports (which I just found in a file from when I moved and had to bring them with me for my current RE since the old office was having technical glitches with their new systems) and wondering what all of this means and if enough testing has been done to find the cause of my IF.
I shouldn't complain really, my old RE (whom I saw a total of 3 times) was worse than my current RE. Dr. H (old RE) was very vague about everything. He sent me for tests and then never explained them to me. I had the ultrasound and the blood tests and then saw him twice after that for Clomid scripts and to go over the results of the tests, but he just said that I don't have PCOS as I don't have any signs other than the abnormal facial hair growth and weight issues.
Dr. R (current RE) has explained things and sent me for more tests, but I haven't seen the full reports from those tests. And though Dr. R tells me more than Dr. H ever did, I still haven't gotten anything other than what I already know (I have symptoms of PCOS but no evidence of having it). I can read these reports, but I don't fully understand what they mean in terms of my IF.
Dr. R is the only RE in my town, but I can't help thinking he's not working with me. I keep wondering if I should ask for a copy of all my reports and send them off to another RE and ask just for a second opinion. I can't afford to travel to find another RE, and though I would love to move out of my current town, I'm not giving up my schooling either. Waiting 2 years isn't an option. Dr. R is treating me, even if I feel it's not enough. I just don't know what to do, I'm just confuzzled!
Replies
I kinda think your RE should be doing a little more monitoring. We tried Clomid once and I realize Clomid never worked for you, but the way I understand the Letrazole, it should work basically the same way. Anyways, I took the Clomid starting day 3 of my cycle, took it for 5 days and then went and had my ovaries U/S on day 10 or 11. She basically was checking to make sure the Clomid had caused a follicle to grow, so that I had something to ovulate. She then had me use the OPK\'s until I got a positive and I am one that actually feels the ovulation happen. I didn\'t get preg that month, but I think it was enough to jump start my ovulating cuz I\'ve felt it every month after that. If there had been no follicle then she would know to use a higher dose of Clomid the next month. If he doesn\'t check your ovaries, how does he know if you even have a follicle to ovulate?? I don\'t know if Letrazole comes in differentt strengths, but if it does, then he could raise it the following month. Or if you have a follicle but don\'t ovulate then he\'d know to use a trigger shot?? I realize the U/S are another trip and a couple hundred $$ BUT they are still alot cheaper than just jumping to IUI. Plus if you don\'t ovulate and he can\'t get that figured out then IUI wouldn\'t work.
If it were me, I\'d try to request more info, bring a list of questions with you, maybe having them on paper will help you remember and him not to just skim over stuff. And maybe his understudy would be the one to meet with if you feel more comfortable with him and he seems to answer more questions anyways.
And see what others say here - they\'ll prob come up with more suggestions/questions, to help you get prepared to gain more knowledge.
I think your RE is brushing you off. You have every symptom of PCOS except the cysts themselves...something is definitely going on. I would try to get a remote consult with another RE, even if this one is far away. You\'re not being taken seriously, and that\'s just not fair.
And by the way...I never get an LH surge until CD19, and I have a 29-30 day cycle...so don\'t give up yet!
I am going to ask for more information next time I get to see my RE. Also I\'m going to write a list of questions down I think. I think I may also ask for copies of all the test reports that Dr. R has done, for my own records (and to get a consult if I decide to do that).
As for the LH surge, I\'m still holding out hope that this works, I\'m just anxious about it I guess. Then again, I\'m anxious in general thanks to life events anyway.